Individual
IMAN MATTOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
8080 E CENTRAL AVE STE 250, WICHITA, KS 67206
(316) 686-7327
(316) 686-1557
Mailing address
8080 E CENTRAL AVE STE 250, WICHITA, KS 67206-2367
(316) 686-7327
(316) 686-1557
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95199822
CA
367500000X
Certified Registered Nurse Anesthetist
227865
OK
367500000X
Certified Registered Nurse Anesthetist
Primary
558169
KS
Other
Enumeration date
11/09/2021
Last updated
07/13/2026
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